Adherence to combined Antiretroviral therapy (cART) among people living with HIV/AIDS in a Tertiary Hospital in Ilorin, Nigeria

Introduction: this study aims to assess the treatment adherence rate among People Living With HIV/AIDS (PLWHA) receiving treatment in a Nigerian tertiary Hospital. Methods: this was a cross-sectional study that assessed self-reported treatment adherence among adults aged 18 years and above who were accessing drugs for the treatment of HIV. Systematic random sampling method was used to select 550 participants and data were collected by structured interviewer administered questionnaire. Results: the mean age of respondents was 39.9±10 years. Adherence rate for HIV patients was 92.6%. Factors affecting adherence include lack of money for transportation to the hospital (75%), traveling (68.8%), forgetting (66.7%), avoiding side effects (66.7%), and avoiding being seen (63.6%). Conclusion: the adherence rate was less than optimal despite advancements in treatment programmes. Adherence monitoring plans such as home visit and care should be sustained

Determinants of Outcome of Abdominal Trauma in an Urban Tertiary Center

Background: Abdominal trauma constitutes a significant cause of potentially preventable mortality. Therefore, knowledge of the determinants of outcome facilitates the development of rational treatment protocols for improving outcome. Objective: To identify the determinants of outcome in patients with abdominal trauma managed in a tertiary health center. Patients and Methods: This is a prospective study of consecutive patients presenting with abdominal trauma to our tertiary health center over a 12-month period. Data regarding patient demographics, injury mechanisms, type of organ injuries, treatment modalities, injury-to-intervention time, and outcomes were documented. The Injury Severity Scores and Revised Trauma Scores were determined. The data were analyzed using the Statistical Package for the Social Sciences version 20. Results: There were 76 patients, 66 males and 10 females, whose ages ranged from 15 to 66 years (mean of 32.9 ± 10 years). Thirty-one (40.2%) patients had blunt abdominal trauma whereas 45 (59.8%) patients had penetrating trauma. There was a mortality rate of 8% predominantly from blunt trauma as compared to penetrating abdominal trauma (12.9% vs. 4.4%). There was a statistically significant difference between survivors and nonsurvivors as regards the means of injury-to-intervention time (25.4 ± 36.4 vs. 67.5 ± 58.2, P = 0.007), the means of Injury Severity Scores (15.1 ± 27.9 vs. 23.7 ± 9.8, P = 0.008), and the presence of brain injury (50.0% vs. 5.6%, P = 0.029). Conclusion: This study has shown that delayed intervention, high Injury Severity Score, and associated significant brain injury were determinants of poor outcomes. Prompt intervention and postoperative management in intensive care definitely improve outcome

Survey of Basic Laparoscopic Training Exposure of Nigerian Postgraduate Trainees

Background: The practice of laparoscopy involves the use of training models that are different from conventional open surgery. These concepts are not captured in the traditional models of surgical residency training. Residency training in surgery has been seen as an ample opportunity for early introduction and training in laparoscopy. Objectives: This study aimed to assess the level of exposure and training experience of some surgical resident doctors in accredited training institutions in Nigeria on laparoscopy. Methodology: A cross-sectional survey was conducted among the resident doctors undergoing revision course in surgery at the National Orthopaedic Hospital, Igbobi, Lagos, and Lagos University Teaching Hospital, Lagos, in March 2018. Using the quantitative method of data collection, a pre-tested structured questionnaire was used to collect information on the demography and training exposure of the residents in laparoscopy. Results: A total of 54 of 96 residents surveyed returned the questionnaire, giving a response rate of 56%. There were 53 (98.1%) males and 1 (1.9%) female. The age range of the respondents was between 30 and 46 years, with a mean of 34.2 ± 3.96 years. Thirty-two (59.3%) respondents had spent at least 2 years training in surgery. Thirty-six (66.7%) respondents had not participated in more than four laparoscopic procedures during their rotation. Forty-six percent of respondents reported that their experience in laparoscopy was mainly by observation of the procedures. Forty-nine (90.7%) of respondents surveyed had not attended any training program in laparoscopy. Eighty-one (81.0%) of respondents had a strong motivation and desire for future practice of laparoscopy. Conclusion: This study revealed that few Nigerian postgraduate trainees sampled in the survey were exposed and had training experience in laparoscopy

An Unusual Cause of Pyogenic Liver Abscess. The Conundrum of Broom Splinter. Report of Two Cases

Pyogenic liver abscess is an uncommon but potentially fatal disease. Very few cases of liver abscess due to foreign bodies have been reported. We report our experience in two patients who were successfully managed for liver abscess due to impaled broom splinter. Broom splinters were swallowed unnoticed during consumption of Jute leaves (Corchorus olitorus) (“Ewedu”) soup. Definitive diagnoses in both cases were made at surgery. This is the first case of broom stick‑induced liver abscess to be reported in the literature

Prevalence and risk factors for falls in urban and rural older adults in Ekiti State, Nigeria

Objectives: This study assessed and compared the risk factors for falls among older adults in rural and urban communities.Design: A comparative cross-sectional approach was used.Setting: The study was conducted among community-living older adults in the rural and urban communities of the most populated Local Government Area (Ado-Ekiti LGA) in Ekiti State.Participants: The study population consisted of 624 persons aged 65 years and above recruited into rural and urban groups using multi-stage random sampling.Main outcome measures: Data collected using validated tools and physical measurements were subjected to binary logistic regression to determine the odds of falls with relevant predictor variables among older adults in both groups.Results: A significantly higher proportion of participants in the urban than the rural group had experienced a fall , and the associated risks include low visual acuity, increasing age, arthritis, hearing impairment, hyperglycaemia and high BMI. Physical activity was a protective factor.Conclusion: This study revealed a high risk of falls among older adults in the urban community. Early diagnosis and management of chronic conditions that increase fall risk and promote physical activity, especially among urban-dwelling older adults, are vital measures to be considered in fall prevention programmes

Self-medication among health workers in a tertiary institution in South-West Nigeria

Introduction: inappropriate self-medication results in wastage of resources, resistance to pathogen and generally entails serious health hazard. This study was undertaken to determine the knowledge, practice and reasons for practice of self-medication among health workers in a Nigerian tertiary institution. Methods: this was a cross-sectional descriptive study conducted among staff of Federal Medical Center Ido-Ekiti, Nigeria. Simple random sampling technique was used to select 305 respondents that were interviewed via a pretested semi-structured questionnaire. Analysis was done using SPSS version 15 and while chi-square test was used to test significance between variables, significant (p value set<0.05). Results: among the 305 respondents interviewed, the age range was 18-52yrs with greater proportion being males (51.8%). Majority of respondents were aware of self-medication (94.8%), but only 47.2% had good knowledge of it. Reasons for practicing self-medication were financial problem (10.8%), mild sickness (10.8%), lack of time (13.4%), knowledge of diagnosis (5.6%), convenience (2.3%) and non-availability of doctors (3.0%). The drugs used by respondents without prescription included analgesics (38.2%), antibiotics (19.0%) anti-malaria drugs (13.3%), and others (29.4%). Conditions for which respondents self-medicated were body pains (14.9%), catarrh (14.9%), headache (14.3%), sore throat (11.5%), diarrhea (11.2%), fever (9.0%) and toothache (5.6%). Conclusion: the study demonstrates that the prevalence of self-medication is relatively high. There is need for health education on the implication and danger of self-medication. There is also need for government to pass and enforce law to restrict free access to drugs.The Pan African Medical Journal 2016;2

Evaluation of knowledge and awareness of invasive fungal infections amongst resident doctors in Nigeria

Introduction: it has been estimated that about 11.8% of the Nigerians suffer serious fungal infections annually. A high index of suspicion with early diagnosis and institution of appropriate therapy significantly impacts on the morbidity and mortality of invasive fungal infections (IFIs).Methods: we conducted a cross-sectional multicentre survey across 7 tertiary hospitals in 5 geopolitical zones of Nigeria between June 2013 and March 2015. Knowledge, awareness and practice of Nigerian resident doctors about the diagnosis and management of invasive fungal infections were evaluated using a semi-structured, self-administered questionnaire. Assessment was categorized as poor, fair and good.Results: 834(79.7%) of the 1046 participants had some knowledge of IFIs, 338(32.3%) from undergraduate medical training and 191(18.3%) during post-graduate (specialty) residency training. Number of years spent in clinical practice was positively related to knowledge of management of IFIs, which was statistically significant (p &lt; 0.001). Only 2 (0.002%) out of the 1046 respondents had a good level of awareness of IFIs. Only 4(0.4%) of respondents had seen &gt; 10 cases of IFIs; while 10(1%) had seen between 5-10 cases, 180(17.2%) less than 5 cases and the rest had never seen or managed any cases of IFIs. There were statistically significant differences in knowledge about IFIs among the various cadres of doctors (p &lt; 0.001) as level of knowledge increased with rank/seniority.Conclusion: knowledge gaps exist that could militate against optimal management of IFIs in Nigeria. Targeted continuing medical education (CME) programmes and a revision of the postgraduate medical education curriculum is recommended.</p

Evaluation of knowledge and awareness of invasive fungal infections amongst resident doctors in Nigeria

Introduction:&nbsp;it has been estimated that about 11.8% of the Nigerians suffer serious fungal infections annually. A high index of suspicion with early diagnosis and institution of appropriate therapy significantly impacts on the morbidity and mortality of invasive fungal infections (IFIs). Methods:&nbsp;we conducted a cross-sectional multicentre survey across 7 tertiary hospitals in 5 geopolitical zones of Nigeria between June 2013 and March 2015. Knowledge, awareness and practice of Nigerian resident doctors about the diagnosis and management of invasive fungal infections were evaluated using a semi-structured, self-administered questionnaire. Assessment was categorized as poor, fair and good. Results:&nbsp;834(79.7%) of the 1046 participants had some knowledge of IFIs, 338(32.3%) from undergraduate medical training and 191(18.3%) during post-graduate (specialty) residency training. Number of years spent in clinical practice was positively related to knowledge of management of IFIs, which was statistically significant (p &lt; 0.001). Only 2 (0.002%) out of the 1046 respondents had a good level of awareness of IFIs. Only 4(0.4%) of respondents had seen &gt; 10 cases of IFIs; while 10(1%) had seen between 5-10 cases, 180(17.2%) less than 5 cases and the rest had never seen or managed any cases of IFIs. There were statistically significant differences in knowledge about IFIs among the various cadres of doctors (p &lt; 0.001) as level of knowledge increased with rank/seniority. Conclusion:&nbsp;knowledge gaps exist that could militate against optimal management of IFIs in Nigeria. Targeted continuing medical education (CME) programmes and a revision of the postgraduate medical education curriculum is recommended

Colorectal carcinoma in Lagos and Sagamu, Southwest Nigeria: A histopathological review

AIM: To study the frequency, gender and age distribution as well as pathological characteristics of colorectal carcinoma (CRC) in Lagos and Sagamu in SW Nigeria